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Pregnancy comes with a host of decisions to be made, including where to give birth.

While most women in the United States give birth in a hospital or birthing center, there are some who choose to have a planned home birth. This number is slowly increasing.

This article looks at what happens when someone plans to give birth at home. It includes information on the benefits, risks, and possible safety concerns.

Fast facts on home births

Here are some key points about home births. More detail and supporting information is in the main article.

A doctor or midwife will decide if a home delivery is a safe option

Some medical organizations are supportive of home births while others remain wary

Women are advised to avoid home birthing if they have certain medical conditions

Planning a home birth

It is up to a doctor or midwife to decide whether or not a home delivery is a safe alternative for a mother and her baby.

A home birth cannot be undertaken for every pregnancy.

A planned home delivery will be attended by a midwife, physician, or both. They will be on hand to check the mother's temperature, pulse, blood pressure, and fetal heart rate.

After the birth of the baby, they will be examined by the midwife or physician, who will also support the mother during the period right after birth. If mother or infant needs to be transferred to a hospital at any point, the midwife or physician will arrange for this.

In the opinion of the ACOG, the safest place for a woman to give birth is a hospital or birthing center. The ACNM strongly feel that a home birth is a safe alternative to giving birth in the hospital setting.

The one thing that both associations agree on is that a home delivery is not appropriate for all women or in all situations. Certain criteria must be met to consider home birthing as an option.

The criteria that should be met to consider a home birth include:

A low-risk pregnancy

Presence of a certified midwife or physician for the birth

Living within 10-30 miles of a hospital and having readily available transportation

Being pregnant with no more than one baby and that they are in the head down position

Undergoing a spontaneous labor, or if the labor was induced, it was done in an outpatient setting

People can have more control of the labor process, such as the ability to move around during labor, choosing a position, bathing, and showering

It may be easier to honor a religious or cultural history

They can be less expensive

Planned home births can offer several potential health benefits, including lower rates of maternal infection and less maternal interventions. Planned home births have also been associated with fewer third- and fourth-degree tears and a reduced need for a cesarean delivery.

Possible risks of a planned home birth

The potential risks and disadvantages of having a planned home birth include:

Inability to receive pain medication during labor and delivery

Mid-labor transfers to hospital, which can occur in as many as 23-37 percent of first-time deliveries

Increased risk of death, seizures, and nervous system disorders in babies

Is a planned home birth safe?

Several studies discuss the safety of home delivery for low-risk pregnancies and deliveries that are attended by qualified birth attendants with access to hospital transfer.

One study published in the BMJ looked at the outcomes of planned home births attended by midwives. The authors came to a positive conclusion:

"Planned home birth for low-risk women in North America using certified professional midwives was associated with lower rates of medical intervention but similar intrapartum and neonatal mortality to that of low-risk hospital births in the United States."

A recent study published in the Journal of Midwifery and Women's Health found that low-risk women "experienced high rates of physiologic birth and low rates of intervention without an increase in adverse outcomes."

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